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目的 探讨全腔镜食管癌根治术联合TP化疗方案对食管癌患者血清肿瘤相关因子及survivin蛋白表达的影响.方法 选择2010年8月～2013年8月川北医学院附属医院接受食管癌治疗的100例患者,依据随机数字表法分为对照组和观察组,对照组50例患者仅接受全腔镜食管癌根治术,观察组50例患者在对照组基础上行术前TP化疗.观察两组手术时间、术中出血量、下床活动时间、并发症发生率和预后情况,同时比较两组治疗前后血清肿瘤标志物[可溶型MHC-I类链相关蛋白A(sMICA)、转录因子YY1 (YY1)、细胞角蛋白19片段抗原21-1(Cy-fra21-1)]、血清肿瘤恶性生物学标志物[基质金属蛋白酶-9(MMP-9)、CD44v、血管内皮生长因子(VEGF)]及survivin蛋白水平.结果 治疗后,两组sMICA、Cyfra21-1、MMP-9、CD44v、VEGF、survivin蛋白水平均较治疗前降低(P＜ 0.05),其中观察组sMICA、YY1、Cyfra21-1、MMP-9、CD44v、VEGF、survivin蛋白明显低于对照组(P＜0.05).观察组术中出血量显著少于对照组,下床活动时间显著短于对照组(P＜0.05),两组手术时间比较差异无统计学意义(P＞0.05).对照组术后并发症发生率显著高于观察组(P＜0.05).对照组患者3年生存率显著低于观察组(P＜0.05).结论 全腔镜食管癌根治术联合TP化疗能够有效下调血清肿瘤相关因子、survivin蛋白表达,疗效显著、并发症发生率低,值得临床推广.“,”Objective To explore the effect of thoracoscopic and laparoscopic esophagectomy combined with TP chemotherapy on serum tumor-related factors and survivin protein expression of esophageal cancer patients.Methods 100 cases of esophageal cancer patients treated in Affiliated Hospital of North Sichuan Medical College from August 2010 to August 2013 were selected.All patients were divided into control group and observation group according to the random number table method,thoracoscopic and laparoscopic esophagectomy was used in control group (50 cases),TP chemotherapy before surgery on the basis of control group was applied in observation group (50 cases).The surgery time,intraoperative bleeding,postoperative activity time,incidence rate of complication and prognosis between two groups were observed.Serum tumor markers [soluble major histo-compatibility complex class Ⅰ chain-related protain A (sMICA),transcription factor YY1 (YY1),cytokeratin 19 fragment antigen21-1 (Cyfra21-1)],malignant biological markers of serum tumors [matrix metalloprotein-9 (MMP-9),CD44v,vascular endothelial growth factor (VEGF)] and serum survivin protein of two groups were compared.Results The sMICA,YY1,Cyfra21-1,MMP-9,CD44v,VEGF,survivin protein of two groups after treatment were lower than before treatment (P ＜ 0.05).The sMICA,YY1,Cyfra21-1,MMP-9,CD44v,VEGF,survivin protein of observation group after treatment were lower than those of control group (P ＜ 0.05).The intraoperative bleeding of observation group was less than that of control group (P ＜ 0.05).The postoperative activity time of observation group was shorter than that of control group (P ＜ 0.05).There was no significant difference in operation time between two groups (P ＞ 0.05).The incidence rate of postoperative complication in control group was significantly higher than that in observation group (P ＜ 0.05).3-year survival rate of control group was significantly lower than that of observation group (P ＜ 0.05).Conclusion Thoracoscopic and laparoscopic esophagectomy combined with TP chemotherapy can significantly decrease the levels of serum tumor-related factors and serum survivin protein expression.Efficacy is significant,the incidence rate of complication is low.It is worthy of clinical promotion.